Travel Agent Request Form
Please only answer the questions that apply to your trip
Contact Information
Your Name:
*
First Name
Middle Name
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
*
Confirmation Email
example@example.com
Best Contact Phone Number:
*
-
Area Code
Phone Number
Preferred Contact Method:
Email
Phone
No Preference
Best Time to Contact:
Morning
Afternoon
Evening
Other
Your Time Zone:
*
Please Select
Abidjan (GMT)
Accra (GMT)
Addis Ababa (GMT+03:00)
Algiers (GMT+01:00)
Asmara (GMT+03:00)
Bamako (GMT)
Bangui (GMT+01:00)
Banjul (GMT)
Bissau (GMT)
Blantyre (GMT+02:00)
Brazzaville (GMT+01:00)
Bujumbura (GMT+02:00)
Cairo (GMT+03:00)
Casablanca (GMT)
Ceuta (GMT+02:00)
Conakry (GMT)
Dakar (GMT)
Dar es Salaam (GMT+03:00)
Djibouti (GMT+03:00)
Douala (GMT+01:00)
El Aaiun (GMT)
Freetown (GMT)
Gaborone (GMT+02:00)
Harare (GMT+02:00)
Johannesburg (GMT+02:00)
Kampala (GMT+03:00)
Khartoum (GMT+03:00)
Kigali (GMT+02:00)
Kinshasa (GMT+01:00)
Lagos (GMT+01:00)
Libreville (GMT+01:00)
Lome (GMT)
Luanda (GMT+01:00)
Lubumbashi (GMT+02:00)
Lusaka (GMT+02:00)
Malabo (GMT+01:00)
Maputo (GMT+02:00)
Maseru (GMT+02:00)
Mbabane (GMT+02:00)
Mogadishu (GMT+03:00)
Monrovia (GMT)
Nairobi (GMT+03:00)
Ndjamena (GMT+01:00)
Niamey (GMT+01:00)
Nouakchott (GMT)
Ouagadougou (GMT)
Porto-Novo (GMT+01:00)
Sao Tome (GMT)
Tripoli (GMT+02:00)
Tunis (GMT+02:00)
Windhoek (GMT+01:00)
Adak (GMT-09:00)
Anchorage (GMT-08:00)
Anguilla (GMT-04:00)
Antigua (GMT-04:00)
Araguaina (GMT-03:00)
Buenos Aires, Argentina (GMT-03:00)
Catamarca, Argentina (GMT-03:00)
Cordoba, Argentina (GMT-03:00)
Jujuy, Argentina (GMT-03:00)
La Rioja, Argentina (GMT-03:00)
Mendoza, Argentina (GMT-03:00)
Rio Gallegos, Argentina (GMT-03:00)
Salta, Argentina (GMT-03:00)
San Juan, Argentina (GMT-03:00)
San Luis, Argentina (GMT-04:00)
Tucuman, Argentina (GMT-03:00)
Ushuaia, Argentina (GMT-03:00)
Aruba (GMT-04:00)
Asuncion (GMT-04:00)
Atikokan (GMT-05:00)
Bahia (GMT-03:00)
Barbados (GMT-04:00)
Belem (GMT-03:00)
Belize (GMT-06:00)
Blanc-Sablon (GMT-04:00)
Boa Vista (GMT-04:00)
Bogota (GMT-05:00)
Boise (GMT-06:00)
Cambridge Bay (GMT-06:00)
Campo Grande (GMT-04:00)
Cancun (GMT-05:00)
Caracas (GMT-04:30)
Cayenne (GMT-03:00)
Cayman (GMT-05:00)
Chicago (GMT-05:00)
Chihuahua (GMT-06:00)
Costa Rica (GMT-06:00)
Cuiaba (GMT-04:00)
Curacao (GMT-04:00)
Danmarkshavn (GMT)
Dawson (GMT-07:00)
Dawson Creek (GMT-07:00)
Denver (GMT-06:00)
Detroit (GMT-04:00)
Dominica (GMT-04:00)
Edmonton (GMT-06:00)
Eirunepe (GMT-04:00)
El Salvador (GMT-06:00)
Fortaleza (GMT-03:00)
Glace Bay (GMT-03:00)
Godthab (GMT-02:00)
Goose Bay (GMT-03:00)
Grand Turk (GMT-04:00)
Grenada (GMT-04:00)
Guadeloupe (GMT-04:00)
Guatemala (GMT-06:00)
Guayaquil (GMT-05:00)
Guyana (GMT-04:00)
Halifax (GMT-03:00)
Havana (GMT-04:00)
Hermosillo (GMT-07:00)
Indianapolis, Indiana (GMT-04:00)
Knox, Indiana (GMT-05:00)
Marengo, Indiana (GMT-04:00)
Petersburg, Indiana (GMT-04:00)
Tell City, Indiana (GMT-05:00)
Vevay, Indiana (GMT-04:00)
Vincennes, Indiana (GMT-04:00)
Winamac, Indiana (GMT-04:00)
Inuvik (GMT-06:00)
Iqaluit (GMT-04:00)
Jamaica (GMT-05:00)
Juneau (GMT-08:00)
Louisville, Kentucky (GMT-04:00)
Monticello, Kentucky (GMT-04:00)
La Paz (GMT-04:00)
Lima (GMT-05:00)
Los Angeles (GMT-07:00)
Maceio (GMT-03:00)
Managua (GMT-06:00)
Manaus (GMT-04:00)
Marigot (GMT-04:00)
Martinique (GMT-04:00)
Mazatlan (GMT-06:00)
Menominee (GMT-05:00)
Merida (GMT-05:00)
Mexico City (GMT-05:00)
Miquelon (GMT-02:00)
Moncton (GMT-03:00)
Monterrey (GMT-05:00)
Montevideo (GMT-03:00)
Montreal (GMT-04:00)
Montserrat (GMT-04:00)
Nassau (GMT-04:00)
New York (GMT-04:00)
Nipigon (GMT-04:00)
Nome (GMT-08:00)
Noronha (GMT-02:00)
Center, North Dakota (GMT-05:00)
New Salem, North Dakota (GMT-05:00)
Panama (GMT-05:00)
Pangnirtung (GMT-04:00)
Paramaribo (GMT-03:00)
Phoenix (GMT-07:00)
Port-au-Prince (GMT-05:00)
Port of Spain (GMT-04:00)
Porto Velho (GMT-04:00)
Puerto Rico (GMT-04:00)
Rainy River (GMT-05:00)
Rankin Inlet (GMT-05:00)
Recife (GMT-03:00)
Regina (GMT-06:00)
Resolute (GMT-05:00)
Rio Branco (GMT-04:00)
Santarem (GMT-03:00)
Santiago (GMT-04:00)
Santo Domingo (GMT-04:00)
Sao Paulo (GMT-03:00)
Scoresbysund (GMT)
Shiprock (GMT-06:00)
St Barthelemy (GMT-04:00)
St Johns (GMT-02:30)
St Kitts (GMT-04:00)
St Lucia (GMT-04:00)
St Thomas (GMT-04:00)
St Vincent (GMT-04:00)
Swift Current (GMT-06:00)
Tegucigalpa (GMT-06:00)
Thule (GMT-03:00)
Thunder Bay (GMT-04:00)
Tijuana (GMT-07:00)
Toronto (GMT-04:00)
Tortola (GMT-04:00)
Vancouver (GMT-07:00)
Whitehorse (GMT-07:00)
Winnipeg (GMT-05:00)
Yakutat (GMT-08:00)
Yellowknife (GMT-06:00)
Casey (GMT+11:00)
Davis (GMT+05:00)
DumontDUrville (GMT+10:00)
Mawson (GMT+05:00)
McMurdo (GMT+12:00)
Palmer (GMT-04:00)
Rothera (GMT-03:00)
South Pole (GMT+12:00)
Syowa (GMT+03:00)
Vostok (GMT+06:00)
Longyearbyen (GMT+02:00)
Aden (GMT+03:00)
Almaty (GMT+06:00)
Amman (GMT+03:00)
Anadyr (GMT+13:00)
Aqtau (GMT+05:00)
Aqtobe (GMT+05:00)
Ashgabat (GMT+05:00)
Baghdad (GMT+03:00)
Bahrain (GMT+03:00)
Baku (GMT+05:00)
Bangkok (GMT+07:00)
Beirut (GMT+03:00)
Bishkek (GMT+06:00)
Brunei (GMT+08:00)
Choibalsan (GMT+08:00)
Chongqing (GMT+08:00)
Colombo (GMT+05:30)
Damascus (GMT+03:00)
Dhaka (GMT+07:00)
Dili (GMT+09:00)
Dubai (GMT+04:00)
Dushanbe (GMT+05:00)
Gaza (GMT+03:00)
Harbin (GMT+08:00)
Ho Chi Minh (GMT+07:00)
Hong Kong (GMT+08:00)
Hovd (GMT+07:00)
Irkutsk (GMT+09:00)
Jakarta (GMT+07:00)
Jayapura (GMT+09:00)
Jerusalem (GMT+03:00)
Kabul (GMT+04:30)
Kamchatka (GMT+13:00)
Karachi (GMT+06:00)
Kashgar (GMT+08:00)
Kathmandu (GMT+05:45)
Kolkata (GMT+05:30)
Krasnoyarsk (GMT+08:00)
Kuala Lumpur (GMT+08:00)
Kuching (GMT+08:00)
Kuwait (GMT+03:00)
Macau (GMT+08:00)
Magadan (GMT+12:00)
Makassar (GMT+08:00)
Manila (GMT+08:00)
Muscat (GMT+04:00)
Nicosia (GMT+03:00)
Novokuznetsk (GMT+07:00)
Novosibirsk (GMT+07:00)
Omsk (GMT+07:00)
Oral (GMT+05:00)
Phnom Penh (GMT+07:00)
Pontianak (GMT+07:00)
Pyongyang (GMT+09:00)
Qatar (GMT+03:00)
Qyzylorda (GMT+06:00)
Rangoon (GMT+06:30)
Riyadh (GMT+03:00)
Sakhalin (GMT+11:00)
Samarkand (GMT+05:00)
Seoul (GMT+09:00)
Shanghai (GMT+08:00)
Singapore (GMT+08:00)
Taipei (GMT+08:00)
Tashkent (GMT+05:00)
Tbilisi (GMT+04:00)
Tehran (GMT+04:30)
Thimphu (GMT+06:00)
Tokyo (GMT+09:00)
Ulaanbaatar (GMT+08:00)
Urumqi (GMT+08:00)
Vientiane (GMT+07:00)
Vladivostok (GMT+11:00)
Yakutsk (GMT+10:00)
Yekaterinburg (GMT+06:00)
Yerevan (GMT+05:00)
Azores (GMT)
Bermuda (GMT-03:00)
Canary (GMT+01:00)
Cape Verde (GMT-01:00)
Faroe (GMT+01:00)
Madeira (GMT+01:00)
Reykjavik (GMT)
South Georgia (GMT-02:00)
St Helena (GMT)
Stanley (GMT-04:00)
Adelaide (GMT+09:30)
Brisbane (GMT+10:00)
Broken Hill (GMT+09:30)
Currie (GMT+10:00)
Darwin (GMT+09:30)
Eucla (GMT+08:45)
Hobart (GMT+10:00)
Lindeman (GMT+10:00)
Lord Howe (GMT+10:30)
Melbourne (GMT+10:00)
Perth (GMT+08:00)
Sydney (GMT+10:00)
Amsterdam (GMT+02:00)
Andorra (GMT+02:00)
Athens (GMT+03:00)
Belgrade (GMT+02:00)
Berlin (GMT+02:00)
Bratislava (GMT+02:00)
Brussels (GMT+02:00)
Bucharest (GMT+03:00)
Budapest (GMT+02:00)
Chisinau (GMT+03:00)
Copenhagen (GMT+02:00)
Dublin (GMT+01:00)
Gibraltar (GMT+02:00)
Guernsey (GMT+01:00)
Helsinki (GMT+03:00)
Isle of Man (GMT+01:00)
Istanbul (GMT+03:00)
Jersey (GMT+01:00)
Kaliningrad (GMT+03:00)
Kiev (GMT+03:00)
Lisbon (GMT+01:00)
Ljubljana (GMT+02:00)
London (GMT+01:00)
Luxembourg (GMT+02:00)
Madrid (GMT+02:00)
Malta (GMT+02:00)
Mariehamn (GMT+03:00)
Minsk (GMT+03:00)
Monaco (GMT+02:00)
Moscow (GMT+04:00)
Oslo (GMT+02:00)
Paris (GMT+02:00)
Podgorica (GMT+02:00)
Prague (GMT+02:00)
Riga (GMT+03:00)
Rome (GMT+02:00)
Samara (GMT+05:00)
San Marino (GMT+02:00)
Sarajevo (GMT+02:00)
Simferopol (GMT+03:00)
Skopje (GMT+02:00)
Sofia (GMT+03:00)
Stockholm (GMT+02:00)
Tallinn (GMT+03:00)
Tirane (GMT+02:00)
Uzhgorod (GMT+03:00)
Vaduz (GMT+02:00)
Vatican (GMT+02:00)
Vienna (GMT+02:00)
Vilnius (GMT+03:00)
Volgograd (GMT+04:00)
Warsaw (GMT+02:00)
Zagreb (GMT+02:00)
Zaporozhye (GMT+03:00)
Zurich (GMT+02:00)
Antananarivo (GMT+03:00)
Chagos (GMT+06:00)
Christmas (GMT+07:00)
Cocos (GMT+06:30)
Comoro (GMT+03:00)
Kerguelen (GMT+05:00)
Mahe (GMT+04:00)
Maldives (GMT+05:00)
Mauritius (GMT+04:00)
Mayotte (GMT+03:00)
Reunion (GMT+04:00)
Apia (GMT-11:00)
Auckland (GMT+12:00)
Chatham (GMT+12:45)
Easter (GMT-06:00)
Efate (GMT+11:00)
Enderbury (GMT+13:00)
Fakaofo (GMT-10:00)
Fiji (GMT+12:00)
Funafuti (GMT+12:00)
Galapagos (GMT-06:00)
Gambier (GMT-09:00)
Guadalcanal (GMT+11:00)
Guam (GMT+10:00)
Honolulu (GMT-10:00)
Johnston (GMT-10:00)
Kiritimati (GMT+14:00)
Kosrae (GMT+11:00)
Kwajalein (GMT+12:00)
Majuro (GMT+12:00)
Marquesas (GMT-09:30)
Midway (GMT-11:00)
Nauru (GMT+12:00)
Niue (GMT-11:00)
Norfolk (GMT+11:30)
Noumea (GMT+11:00)
Pago Pago (GMT-11:00)
Palau (GMT+09:00)
Pitcairn (GMT-08:00)
Ponape (GMT+11:00)
Port Moresby (GMT+10:00)
Rarotonga (GMT-10:00)
Saipan (GMT+10:00)
Tahiti (GMT-10:00)
Tarawa (GMT+12:00)
Tongatapu (GMT+13:00)
Truk (GMT+10:00)
Wake (GMT+12:00)
Wallis (GMT+12:00)
Basic Trip Information
Interested in booking (check all that apply):
*
Flight
Hotel/Resort
Car Rental
Cruise
Other
Departing From:
*
Where are you departing from?
Are you planning a group trip? (10 or more constitutes a group; group request form will be sent. Group planning rate will apply):
Yes
No
As of now, yes
As of now, no
Which destination did you have in mind?:
*
List all countries, or cities you are seeking a quote for.
Departure Date:
*
-
Month
-
Day
Year
Date
Return Date:
*
-
Month
-
Day
Year
Date
Are your travel dates flexible?:
*
Yes
No
Maybe
What is your budget?:
Payment Options:
Full Payment
Full Payment Deposit with Payment Plan (if applicable)
Monthly Payments (if applicable)
Traveler Information
# Of Adults:
# Of Children:
Traveler Information:
Full Name
DOB
Passport (if flying out of the USA)
TSA Precheck # (if applicable
Traveler #1
Traveler #2
Traveler #3
Traveler #4
Traveler #5
Traveler #6
Traveler #7
Traveler #8
Traveler #9
Traveler #10
Children's Ages (if applicable):
Applicable Discounts (check all that apply):
AARP Senior Discount
Military Discount
Other
Membership Number (if applicable):
Are Passports updated (if applicable):
Please Select
Yes, they are up to date
No, they need to be updated
I am in the process of updating my passport.
Airline Preferences
Preferred Airline (if applicable):
Preferred Class (if applicable):
Would you like me to provide roundtrip transportation to and from the airport? (Transportation will include a ride to hotel on arrival from airport & transportation to airport from hotel upon departure date):
Yes, regular car transportation
Yes, SUV transportation
No transportation needed
Car Rental
Company Preference (if applicable):
Vehicle Type:
Large Group Transportation (check all that apply):
Charter Bus
Multiple Cars/SUV
Large Vans
Limousine/Party Bus
Insurance:
Yes, I have my own full coverage policy
No, I need to purchase from the rental company
Accommodations
Property Star Rating:
Property Type:
Apartment Condominium
Hotel
Vacation Rental (i.e. AirNBNB)
Bed & Breakfast Hostel/Backpack Resort
Property Amenities:
Adult Only
All-Inclusive
Air Conditioning
Children's Amenities
Free Breakfast
Free Transportation
Free Parking
Free High-Speed Internet
Kitchen
Entertainment
Pets Allowed
Pool
Spa & Other
Room Type:
Room View:
How many rooms do you need?:
Accessibility:
Accessible Bathroom
In-room Accessibility
Roll-in Shower
Wheelchair Accessible
Rewards # (if applicable):
Need to be close to a specific venue or area? Enter it here:
Are there any other details I need about room accommodations?:
Ex. guest preferences not listed.
Activities
Interested in these activities (check all that apply):
Concerts & Shows
Private/Romantic Shopping
Sightseeing & Tours
Theme Parks
Water Sports
Shopping
Looking for a specific Activity?:
Last Minute Details
Are there any other details I need to be aware of for booking your travel?:
Ex. Food, allergies, restrictions, etc.
If you have any files you need to upload, upload here:
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